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Bilateral or unilateral amplification: is there a difference? A brief tutorial.

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George T Mencher, Adrian Davis. 2006. Bilateral or unilateral amplification: is there a difference? A brief tutorial.. https://doi.org/10.1080/14992020600782568

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Fitting strategies and candidature criteria for unilateral and bilateral hearing aid fittings.

In this paper, hearing aid fitting strategies are reviewed and candidature criteria for unilateral and bilateral fittings are discussed. Fitting strategies are primarily governed by the objectives of hearing aid fitting that can be set in different ways. Based on common goals, fitting strategies can be broken down into three stages: (1) basic fitting, (2) fine-tuning and (3) verification and validation. A fine-tuning concept basing on so-called meta-controllers is described and the issue of bilateral fitting strategies is discussed. In a first order approach, bilateral hearing aids can be fitted in parallel as unilateral aids, followed by bilateral fine-tuning, making sure that loudness is balanced and overall loudness is accepted. Parallel fitting of bilateral aids is more favourable than sequential fitting to avoid rejection because of a negative experience with unilateral amplification due to difficulties in disadvantageous listening situations. Candidature criteria are presented by means of a flow chart structuring the decision making process and arriving at the conclusion that bilateral fitting should be considered the normal case. If there is any doubt about the benefit of bilateral fitting, a trial with bilateral aids should be performed.

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SII and fit-to-target analysis of compression system performance as a function of number of compression channels.

This work was undertaken to answer the question, 'How does the speech audibility/fit-to-gain-target provided by compression change with number of channels?' For each of 957 audiograms and a given number of compression channels, the channel crossover frequencies were set either to maximize the SII (speech intelligibility index) for low- and high-level speech spectra, or to optimize the fit-to-gain targets from the Cambridge method for loudness equalization (CAMEQ). The audiograms comprised all common configurations, and losses ranged from mild to severe. Use of these computational procedures allowed the predicted, channel-number-based performance to be determined separately from the effects of other compression parameters. From one to five channels were sufficient to yield predicted speech recognition performance within 5% of maximum for 90% of the 'mild' and 'moderate' audiograms. Three to nine channels were necessary for the same level of predicted performance for 90% of the 'severe' audiograms. Four channels or fewer were sufficient to produce less than 5 dB rms error in fit to CAMEQ targets for 90% of all audiograms.

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